患者报告的逐渐恶化显示出超出MS亚型的进展
Jie Guo1,2, Tomas Olsson1, Lars Alfredsson3,4
1Department of Clinical Neuroscience, Center for Molecular Medicine, L8, Karolinska Institutet, 171 76, Stockholm, Sweden.
Journal of neurology
|February 6, 2026
概括
患者报告的多发性硬化症 (MS) 的逐渐恶化可能表明疾病的进展早于临床分类. 这突显了将患者经验纳入常规监测的价值,以更好地管理复发性复发性多发性硬化症 (RRMS) 和二次进展性多发性硬化症 (SPMS).
科学领域:
- 神经学 神经学
- 临床研究 临床研究
- 患者报告的结果
背景情况:
- 复发性复发性多发性硬化症 (RRMS) 的逐渐恶化可能会在过渡到二级渐进性多发性硬化症 (SPMS) 之前发生.
- 了解患者报告的恶化经历对于早期检测和管理至关重要.
- 评估患者报告与临床分类之间的一致性至关重要.
研究的目的:
- 量化MS患者自我报告的逐渐恶化.
- 评估患者报告的恶化和临床记录的MS亚型 (RRMS与SPMS) 之间的一致性.
- 为了确定与患者报告和临床分类之间的不一致性相关的基线预测因素.
主要方法:
- 从基于人口的研究 (2005-2019) 中对发生RRMS的1640名参与者的分析.
- 利用了2021年对患者报告的逐渐恶化的随访调查.
- 使用后勤回归和Kaplan-Meier估计,使用Cox比例危险模型来分析临床数据 (扩展残疾状况表 - EDSS) 和来自瑞典MS注册的亚型分类.
主要成果:
- 24%的RRMS参与者和23%的SPMS参与者报告了不一致的恶化状态.
- 自我报告的恶化与达到EDSS 3和EDSS 4的风险更高相关.
- 在RRMS中,年龄较大和更高的基线EDSS预测了自我报告的恶化. 在SPMS中,自我报告的恶化在临床分类之前平均4.1年.
结论:
- 患者报告的逐渐恶化是MS中残疾累积的有价值指标.
- 与正式的亚型重新分类相比,患者报告可能有助于更早地识别疾病进展.
- 建议将结构化的患者报告结果纳入常规多发性硬化监测中.
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